GDP节拍方案对老年复发性及难治性非霍奇金淋巴瘤的临床效果分析

Efficacy of GDP metronomic chemotherapy for relapsed and refractory non-Hodgkin’s lymphoma in the elderly

摘要:

目的 探讨吉西他滨、地塞米松联合顺铂（GDP）节拍化疗方案对老年复发性及难治性非霍奇金淋巴瘤（NHL）的临床效果及不良反应。方法 选择2012年1月至2015年1月西安市中心医院血液科收治的老年复发性及难治性NHL患者18例，明确诊断后采用GDP节拍化疗方案进行治疗，治疗后对临床疗效、不良反应进行评估。结果 B细胞NHL患者中完全缓解（CR）3例、部分缓解（PR）2例，T细胞NHL患者CR 3例、PR 1例，总有效率（ORR）为50%，治疗过程中无治疗相关死亡。根据WHO制定的化疗药物毒副反应评价标准，患者治疗后主要不良反应主要集中在0～Ⅰ级，Ⅳ级并未发生，肝肾毒性轻微。发生不良反应主要为骨髓抑制及胃肠道反应，未发生明显的神经毒性及心脏毒性。结论 GDP节拍化疗方案是治疗老年复发性及难治性NHL的有效方案，具有更低的化疗毒副作用的发生，值得进一步推广。

Abstract:

Objective To investigate the efficacy and side effects of metronomic chemotherapy of gemcitabine, dexamethasone and cisplatin (GDP) for elderly relapsed and refractory non-Hodgkin’s lymphoma (NHL). Methods Eighteen elderly patients with identified relapsed and refractory NHL admitted in our institute from January 2012 to January 2015 were enrolled in this study. They were all treated by GDP metronomic chemotherapy. Clinical efficacy and adverse reactions were evaluated. Results For the patients with B-cell NHL, there were 3 cases obtaining complete remission (CR), and 2 cases of partial remission (PR), and for those with T cell NHL, there were 3 cases of CR and 1 case of PR. The total effective rate of the cohort was 50%, and no treatment-related deaths were found during follow-up. According to the evaluation criteria for chemotherapy toxicity established by WHO, the major adverse reactions were mainly concentrated in 0 ?Ⅰ degree, no Ⅳ degree was seen, and the liver and kidney toxicity was mild. The main side effects were myelosuppression as well as gastrointestinal reactions. No obvious neurotoxicity and cardiotoxicity occurred. Conclusion GDP metronomic chemotherapy is effective in the treatment of elderly relapsed and refractory NHL, which has a lower incidence of side effects and worthy of further promotion.